Xeris Pharmaceuticals has teamed up with the American Diabetes Association (ADA) to raise awareness of the importance of prescribing glucagon, positioning the partners to address a fundamental barrier to the use of products such as its Gvoke.
The FDA approved Gvoke, a ready-to-use glucagon product, for the treatment of severe hypoglycemia in 2019. The format is potentially more convenient than traditional glucagon kits from the likes of Fresenius Kabi and Amphastar, but Xeris has struggled to penetrate the vast opportunity. Xeris said it ended 2024 with a 35% market share, but the vast majority of people at risk of low blood glucose don’t carry an emergency kit.
Supported by Xeris, the ADA wants to rectify low rates of glucagon prescriptions. The multi-year pact between the organizations will support development of education materials and training resources for healthcare professionals and people living with diabetes. A push to educate those groups on who is at risk for severe hypoglycemia and should have glucagon is also on the agenda.
The roadmap covers problems that Xeris has identified as barriers to the growth of Gvoke. ADA guidelines state that “glucagon should be prescribed for all individuals taking insulin or at high risk for hypoglycemia” and that ready-to-use preparations are preferred. Despite that, uptake of Gvoke and rival ready-to-use kits is low.
Speaking at a Piper Sandler event last month, Kevin McCulloch, chief operating officer at Xeris, estimated that 15 million people with diabetes in the U.S. are at “outsized risk of having their blood sugar go too low.” Yet, McCulloch said, only around 1 million people carry a glucagon product—and he claimed to know why.
“We find that the No. 1 reason that a prescriber doesn't prescribe Gvoke might surprise you: It’s they don't remember. It isn't any of the other things that you might traditionally associate with barriers to the adoption of pharmaceuticals. It's actually in remembering,” McCulloch said. “Very busy clinicians treating diabetes have a hard time remembering something like this that's brand new.”
According to McCulloch, Xeris is the only glucagon company “out there advocating for the new guidelines and promoting in the space.” Amphastar's intranasal glucagon dry powder, Baqsimi, and Novo Nordisk’s dasiglucagon auto-injector, Zegalogue, compete with Gvoke. McCulloch said he had yet to see the rivals make a big contribution to the awareness push as of last month.
“We're still really not hearing much from others, and we'd welcome more noise out there to create more awareness,” McCulloch said. “We think this is really just the reason for the delta between who has it and who should have it.”